Days that draw attention to mental health and mental illness are bittersweet for me.
Working in the mental health field means that I am, on a daily basis, on the front lines of helping others on the road to recovery, whether that means teaching and practicing coping skills for depression and anxiety, processing and overcoming trauma, finding alternatives to self-harm or restrictive eating or substance use, or any other number of therapeutic activities. My clients range from five to twenty, and each of them has their own story, their own journey, and they’re all at different points on that journey. I feel so blessed, every day, to be there to watch them grow and change as they learn more about themselves and take steps—slow steps, baby steps, whatever is the right pace for them—to get to a place where they are safe, and comfortable, and ultimately, hopefully, happy. As stressful and infuriating as my job can be, I deeply love the work that I do.
For me, the part of World Mental Health Day that is the most difficult is the part that is personal.
To be a therapist with mental illness is to feel like a walking contradiction on good days and a hypocrite on bad ones. It’s constantly wondering whether or not it’s safe to self-disclose, not to clients, but to co-workers and supervisors, wondering if they’ll treat you differently if they know that you might be closer to clients at the beginning of their therapeutic journey than to those at the end. It’s teaching coping skills and feeling hope for your clients and frustration with yourself, the constant questioning of why these skills don’t work for you, or at the very least, why you can’t just teach them to yourself.
A note: You can’t practice CBT on your own brain. It doesn’t work.
I don’t know exactly what DSM codes my own therapist has on her paperwork for me, and I don’t spend my own time with that brick of a book diagnosing myself. I know enough about my own mind to acknowledge that I have struggled with depression and anxiety for years, likely for longer than I’ve understood the concepts. It’s only been in the last few years that I’ve realized that the way my mind works isn’t typical. It’s not typical to have to spend five minutes taking deep breaths to work up the courage to make a phone call, to lie awake at night terrified that a conversation in fourth grade might come back to haunt you, to be suddenly struck, in the middle of a perfectly lovely day, by a wave of thoughts that everything you’ve done amounts to nothing, and that you’ll never be the person you thought you could be when you were little. It’s not typical to have to force yourself through things like taking a shower or getting dressed because the very idea of movement seems overwhelming and exhausting, to burst into tears at the smallest provocation, to sit in a bathtub and wonder what would happen if you just put your head under water and let it stay there. It’s not typical to wonder what the world would be like without you in it, to glance at telephone poles and road dividers and wonder what would happen if your car slid on wet pavement or ice. To not want to kill yourself per se, but to think, sometimes, that it would be okay to fall asleep, and stay that way.
Combining all of this with a chronic physical illness compounded things over the past few years. Study after study has found correlations between chronic pain and depressive disorders, and they’re so wrapped up together that it’s impossible to distinguish cause and effect. The addition of pain to existing depressive and anxious symptoms can take an okay day to one where leaving a bed is impossible. Guilt runs rampant; you tell yourself, you should be able to do this, you’re weak, you’re letting everyone down. This is why no one wants to spend time with you.
(The rational therapist’s mind knows that these are intrusive thoughts, but an anxious mind is louder, a depressive mind more poetic, and the rational mind has a soft voice and is easily overpowered.)
This year, I took the radical step of putting myself into therapy, and that step in and of itself was terrifying. I was scared that a therapist would tell me that I wasn’t fit to work with clients, that until I got my own shit under control that there was no way I could practice as a clinician. After the brief, horrific therapy attempt I made in college, trying again, in a clinical community as small as the one in Berkshire County, made my skin crawl. I’ve been hugely lucky to find a therapist who is kind and comforting and candid, who allows me to take of my therapist hat while using my own background and knowledge to help me understand the way my own mind works—or rather, doesn’t. These last few months in therapy have been terrifying in their vulnerability, but I feel so, so glad that I’ve taken that step.
But even therapists aren’t immune from stigma, from repeating the same harmful statements that keep people who could benefit from treatment from seeking it. I recently had a conversation with a professional who’s been in the field longer than I’ve been alive, and her offhand comment of “Well, there are some people who can solve their own problems, and others who need someone to help them do it, but it really shouldn’t be for everyone” made me feel nauseous and judged. I still feel my heart jump into my throat when I mention my therapist to a co-worker, and I watch their micro-expressions for the tiniest hint of judgment or disappointment. I put on a façade of functionality, because even I have convinced myself that there is a time and place to acknowledge my own mental health needs, and those times are limited, those places few.
I hesitated before writing or posting this tonight, and part of that hesitation came from the internalized stigma I’m still trying to overcome. But World Mental Health Day is important. It’s so important that we tell these stories, that we take these thoughts and feelings out of the darkness and bring them forward so that people know that they are not alone. Depression and anxiety are still daily struggles for me, and will almost certainly remain so for a long time, but even compared to a few short months ago, I feel safer, more prepared to manage those feelings simply by acknowledging that they are there.
For any of my friends who are struggling with mental illness, I urge you to take a step—however small—to move to a safer place. Confide in someone. Start a journal. Reflect on the positive moments in your day, whether it was a hot cup of coffee or snuggles from a pet. Visit a therapist, if that’s something you can do. Ask for help, if you’re feeling unsafe. But know that you are not alone. That however loud anxiety brain shouts, whatever poetic words of despair depression feeds you, that you are loved, and cared for, and the world wants you to stay.